“What, so like you can’t have a life outside medicine?”:attitudes and practices of medical students in relation to digital professionalism

Background and purpose Professionalism is a core tenet of being a doctor and is both required by the General Medical Council1, and expected by society. Medical students are also expected to act professionally2. Social networking sites such as Facebook and Twitter are increasingly pervasive and this has serious implications for online professionalism of doctors and medical students 3-6. This study aimed to discover more about how medical students think, feel and behave in relation to social networking. The research questions were designed to explore their current use of social media, their control over their identity online and their awareness of unprofessional content on social media sites and its implications. Methodology Second year medical students at Lancaster Medical School, were invited to participate in focus group discussions. Analysis of the focus group and paired interview used an iterative coding procedure7. Results The students primarily consider Facebook to be for social purposes, although closed groups are used to support learning. YouTube is also used for learning; however content is viewed, not created. The students consider professionalism to be important in similar ways online and offline, however, they understand that social media brings its own complexities. They became aware of these issues during their medical school career, but areas of confusion remain. Maintenance of patient confidentiality is considered essential and students are highly aware of the importance of their professional online identity and privacy settings. The finer details of what constitutes unprofessional behaviour are unclear, with different perceptions expressed about the extent to which this should change their behaviour both on and offline. They believe students should be treated more leniently than doctors as they are still learning. A finding of concern was that they felt unwilling to challenge unprofessional behaviour online, especially if seniority was an issue. Discussion and Conclusions These results expand the understanding of online professional identity development in medical students and raise questions, particularly in relation to personal-professional boundaries and whistleblowing. References: 1. General Medical Council. Good Medical Practice. London: General Medical Council; 2009 2. General Medical Council. Medical Students: professional values and fitness to practice. London: General Medical Council; 2009 3. Shore R, Halsey J, Shah K, Crigger B-J, Douglas S. Report of the AMA Council on Ethical and Judicial Affaris: Professionalism in the Use of Social Media. The Journal of Clinical Ethics. 2011;22(2): 165-72. 4. Thompson LA, Dawson K, Ferdig R, Black EW, Boyer J, Coutts J, et al. The intersection of online social networking with medical professionalism. J Gen Intern Med. 2008;23(7): 954-7. 5. MacDonald J, Sohn S, Ellis P. Privacy, professionalism and Facebook: a dilemma for young doctors. Med Educ. 2010;44(8): 805-13. 6. Ellaway R. Digital professionalism. Med Teach. 2010;32: 705-7. 7. Miles M, Huberman AM, Saldana J. (eds.) Qualitative Data Analysis: A methods sourcebook. 3rd Edn. Thousand Oaks, CA: SAGE Publications; 2013